Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review.
Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review.
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DOI：
10.1183/09031936.00193413
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发表时间：
2014-06
期刊：
影响因子：
--
通讯作者：
Lönnroth K
中科院分区：
文献类型：
--
作者：
Tanimura T;Jaramillo E;Weil D;Raviglione M;Lönnroth K
为了制定适当的策略来改善金融风险保护，我们对结核病患者和受影响家庭面临的经济负担进行了系统的文献综述。平均总费用从55美元到8198美元不等，未加权平均为847美元。平均而言，直接医疗费用占总费用的20%(0~62%)，直接非医疗费用占20%(0~84%)，收入损失占60%(16~94%)。总费用的一半是在结核病治疗之前发生的。平均而言，总成本相当于报告的年个人的58%(5-306%)和报告的家庭收入的39%(4-148%)。在穷人和耐多药结核病患者中，费用占收入的百分比特别高。通常报道的应对机制包括借钱和出售家居用品。结核病患者的总成本可能是灾难性的。收入损失往往构成患者最大的财务风险。除了确保医疗服务得到公平的融资并以将直接和间接成本降至最低的方式提供外，还需要确保结核病患者和受影响的家庭获得适当的收入替代和其他社会保障干预措施。成本和收入损失使结核病患者面临经济风险，需要通过社会保护干预来缓解。http://ow.ly/sqgRU
In order to inform the development of appropriate strategies to improve financial risk protection, we conducted a systematic literature review of the financial burden of tuberculosis (TB) faced by patients and affected families. The mean total costs ranged from $55 to $8198, with an unweighted average of $847. On average, 20% (range 0–62%) of the total cost was due to direct medical costs, 20% (0–84%) to direct non-medical costs, and 60% (16–94%) to income loss. Half of the total cost was incurred before TB treatment. On average, the total cost was equivalent to 58% (range 5–306%) of reported annual individual and 39% (4–148%) of reported household income. Cost as percentage of income was particularly high among poor people and those with multidrug-resistant TB. Commonly reported coping mechanisms included taking a loan and selling household items. The total cost of TB for patients can be catastrophic. Income loss often constitutes the largest financial risk for patients. Apart from ensuring that healthcare services are fairly financed and delivered in a way that minimises direct and indirect costs, there is a need to ensure that TB patients and affected families receive appropriate income replacement and other social protection interventions. Costs and income loss put people with TB at financial risk, requiring mitigation with social protection interventions http://ow.ly/sqgRU
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